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Although either bending forward or the 45° rotative prone position is recommended for B2 drainage, elevation of B2 by > 45° from the horizontal was more often observed in the latter position (47 of 54 lungs; Fig 4, top right, B) than in the former. The 0 angle for B2 ranged from 15.0 to 75.0° (mean, 42.5 ± 15.0°) when bending forward; in the 45° rotative prone position, it ranged from 20.0 to 85.0° (mean, 55.6. ± 14.4°).

Among patients with explicit directives, the directive was DNR for 50%, whereas the “default” directive implied for all patients who had not explicitly stated their preference was to perform CPR. Even explicit directives are often contingent on a prognosis that may still be uncertain at the onset of critical illness, and other limitations of such directives have also been identi-fied. To the extent that critical illness can be anticipated, early discussion with the patients with lung cancer about likely outcomes and burdens of ICU treatment will help to promote concordance of care goals and plan with the patient’s own preferences.

To minimize this possibility, we used a withdrawal time of five minutes; this has been shown by other investigators to give reliable results at the low COs achieved by CCCM. In addition, as previously noted, we sampled blood from the thoracic aorta immediately after completing the five-minute reference sample withdrawal, and in all cases we found minimal radioactivity present, indicating complete clearance of microspheres in the central circulation. As a check to ensure adequate mixing of injected microspheres with blood, we also counted samples from the left and right cerebral hemisphere separately. In all dogs the specific activity in the two hemispheres was almost identical. buy levaquin online